GRASSROOTS: The GMT Initiative Blog

Grassroots reports on the work of amfAR-supported research teams and advocates responding to the devastating impact of HIV among gay men, other men who have sex with men, and transgender individuals (collectively, GMT).

I
recently left Colombo, Sri Lanka, after spending three lovely days with
colleagues at Diversity
and Solidarity Trust (DAST). amfAR is supporting DAST to
work with the owners and staff at several male massage centers in Colombo,
which at times can act as fronts for male sex work. DAST has
proposed to assist the men in receiving formal massage therapy certificates, in
order to increase their likelihood of receiving more money for their massage services. During
my visit, they also discussed opening an English language class to assist the
masseurs in providing services to higher paying clients.

DAST is already promoting
safer sex, HIV testing and counseling, and social support for the men on a
regular basis. They are focusing on “test and treat” so that if someone is infected,
they can make sure they are on treatment, lowering the probably of spreading
HIV to others. I also met with a few masseurs who let me know they were
from rural areas, and that their income from massage work assists with their
studies, and supports family back home. They told me they “never” practice
penetrative sex in their work, but I was not convinced.

An advertisement for a male massage parlor working with DAST.

Unfortunately,
several massage centers have recently been raided due to various issues,
including illegal drug use. In an extreme case, some masseurs and clients
were arrested. As a result, some male masseurs have shifted to off-site
“house calls” for their effort, making it very challenging for DAST to
implement their program.

However,
a larger challenge for DAST is the infighting, back stabbing, and sabotage occurring
between various Sri Lankan LGBT-identified organizations. There are a several
other local organizations, which all seem to serve different populations
amongst the LGBT community—LGBT of higher means, LGBT youth, lesbian women,
openly identified gay men, transgender individuals, etc. However, to
international donors and networks, it seems that at times these groups and
individuals sabotage each other. Clearly, there is a history of corruption
among some individuals, as well as years of built-up mistrust. It seems very
self-defeating to me.

I
also had a long and fruitful conversation with colleagues representing various
UN agencies and The Family
Planning Association of Sri Lanka—all of whom were very supportive of DAST’s and
others’ work related to LGBT issues. However, they confirmed the infighting and
were not sure what to do about it.

As
many of us know, infighting like this is not unique to Sri Lanka. Such
infighting exists nearly everywhere and can be destructive. But as a
seasoned activist, I recognize that such infighting is natural, especially when
marginalized people are forced to fight over limited resources. However, as a
movement, we need to unite our efforts to challenge a homophobic and trans-phobic
world, and not allow internal conflicts slow our progress.

I
am honored to work with activists throughout the world and I have noticed that
activists in places under extreme threat seem to be more likely to work
together. In a way, having a crisis encourages more unity to defeat a
common opposition. For example, the LGBT activist movement in Jamaica has
had to deal with extreme violence against their community for years—both
physical and verbal (especially in the form of popular music). I’m not
sure exactly what the secret is, but, from my perspective, the Jamaican LGBT
organizations seem to be united.

Similarly,
I look to Uganda, where groups who once struggled through severe infighting
have come together to stand united against a religiously based, state-sponsored
assault on their livelihoods (even more notable after the death of David Kato—one
of their key leaders).

Back
to Sri Lanka—I also spent a lot of time chatting with a charming and peaceful
gay activist who is working on “peace-building.” Sri Lanka is emerging
from more than 25 years of civil strife. The government of Sri Lanka and
global human rights donors have responded to this situation by investing in
peace and reconciliation processes—working to build trust between ethnic
groups. During our conversations, a huge light bulb went on in both our
heads. We recognized that the work he was doing as a peace builder for the
nation is sorely needed within the LGBT community in Sri Lanka as well. I
left quite encouraged, as this activist seemed to be quite excited about
applying his skills to build peace in the LGBT community. Time will tell, but
I left with a whole lot of hope for this beautiful country.

Today,
I’m in Dhaka, Bangladesh, meeting with colleagues at the Bandu Social Welfare
Society (BSWS). amfAR
is funding BSWS as part our “Evidence in Action” project—funded
by ViiV Healthcare
Positive Action
and the Elton John AIDS Foundation in order to increase
the knowledge base about effective, community-based HIV/AIDS services for gay men, other men who
have sex with men, and transgender individuals (collectively, GMT).

The
project is working with past amfAR grantees in need of more formalized
evaluations to scale up their programs. BSWS is pretty amazing, having
been around for 15 years serving sexual minorities. For their current
project with amfAR, they are tackling very challenging issues in Bangladesh, working
with gay men and other men who have sex with men (MSM) who are living with
HIV.

Staff and beneficiaries at Bandu Social Welfare Society

I
was honored to have lunch with a male couple—very much in love, and both living
with HIV. One was a bit more effeminate (he did ALL the talking) and he told
me about their struggle to disclose their HIV statuses amongst their families
and their community. In fact, they are living openly as a couple and as HIV
people. Pretty amazing considering the double stigma. That is why BSWS is
engaging them—to figure out what has made them so courageous, and how they can
inspire others

amfAR
has secured an external evaluator to work with BSWS and conduct a formal
evaluation of the project, which also includes helping GMT living with HIV
adhere to medication and find social support. They will also be launching a
campaign to reduce HIV stigma (sadly, 30 years into the epidemic, still quite
strong in Bangladesh) among GMT individuals in general. Whatever the
results of the evaluation, BSWS and amfAR will have data to offer to larger
donors—including the Bangladesh Ministry of Health—which will hopefully
encourage scale-up investment. We should have results in about a year, so
watch this space!

I am just leaving Tarapoto, Peru, a small town in the middle of
the Peruvian jungle. I spent the past two days with Diversidad San Martinense
(DISAM), a youth-led organization for and by gay men, other MSM, and transgender
individuals (GMT). Peru is an interesting place in terms of government support
for HIV programming for at-risk populations. Peru is one of just a few
developing nations that have world-class researchers working with GMT, and the
government is increasingly showing support for broader civil and human rights
for these populations. Nevertheless, societal stigma and discrimination is
rampant and still threatens access to vital services.

DISAM is receiving amfAR funding (through a grant from the Elton
John AIDS Foundation)—the organization’s first ever official grant—to analyze
gaps in health services for GMT and to work with health professionals in filling
those gaps.

I attended a working lunch with the members of DISAM and 10
local policymakers, health professionals, local authorities, and other
stakeholders to discuss the issues facing GMT in Peru. I was pleased to hear
that several people in the room were concerned about security and were working
with health personnel to increase access to testing and treatment. The objective
of the meeting was to capitalize on the power and position of these stakeholders
to get concrete plans in place for helping GMT in Peru. DISAM has already been
able to get two orders passed in the San Martin Province that state that
discrimination based on sexual identity and gender is not permitted in public
places. Although these orders are not official laws, they mark positive first
steps towards inclusive public policy in Peru for GMT. Alex, the director of
DISAM, acknowledged that Peru is ahead of most countries in the region in terms
of services and policies for GMT, and was optimistic that more changes were
coming.

I left Peru with a great sense of pride. DISAM reminded me that
a small group of people really can make a positive impact.